Search

Thoracic radiotherapy is a usual treatment for lung cancer. Early-stages may be treated in stereotactic mode while locally advanced stages are usually treated with conventional radiotherapy mode. Pulmonary function tests show that thoracic irradiation has no impact on lung volume such as forced expiratory volume in one second (FEV1) or forced vital capacity (FCV). However, some studies found that CO (carbon monoxide) diffusing capacity (TLCO) may be altered under thoracic radiotherapy. DLCO alteration is usually symptomatic of either a lesion in the alveolar membrane or a pulmonary capillary alteration. Pulmonary diffusion may be also appreciated by the NO (azote monoxide) diffusion capacity. Moreover, using a double measurement of NO and CO diffusing capacities permit to assess which lung compartment (capillary or membrane) is affected. CONORT is an observational prospective monocentric study, aiming to assess the CO and NO diffusing capacity (as well as other pulmonary function tests) during thoracic radiotherapy. Inclusion criteria are patients with lung cancer, treated by thoracic radiotherapy (conformational or stereotactic), who signed consent. Pulmonary function tests are performed before, during, at the end and six weeks and six months after thoracic irradiation. To estimate a difference of 15% in diffusing capacity test, we have to include 112 patients with a 90% power and a 5% alpha risk. Four months after beginning, 36 patients were included. Preliminary data will be presented at the SFRO meeting., (Copyright © 2014 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.)

Distal metastases are classically situated below the knee or elbow. However, metastases of the extremities: wrist and hand, or ankle and foot, have etiological and histological characteristics. We report one case of bone metastasis and one case of soft tissue metastasis. The distal bone metastases are often solitary. Bronchial cancers represent the most frequent cause of distal metastases (20% of all cases). They are responsible for 50% of distal metastases of the upper limb and more often occurs as a squamous cancer. Their localization may sometimes reveal a bronchial cancer, and so allow curative surgery. The metastases of soft tissue are exceptional. In the literature, only 2 cases of soft tissue metastasis of bronchopulmonary cancer are described. Clinically, it is a painful swelling preserving the under lying bone. The prognosis is always one of bronchial metastasis cancer with an average survival of 3-6 months.